Individual
MR. RUSSELL QUENTIN SUMMERS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
806 MOCKINGBIRD LN APT 303, TOWSON, MD 21286-3611
(443) 912-9698
Mailing address
806 MOCKINGBIRD LN APT 303, TOWSON, MD 21286-3611
(443) 912-9698
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04010
MD
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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